Software and ICT 2010 Finalists
Neil Porter accepted the finalists trophy on behalf of Danny Pearson from Sheffield Teaching Hospitals NHS Foundation Trust with his innovation “Integrated Haemato-Oncology Diagnostic Software”.
In order to link the HODS network of referring hospitals, HODS has developed a centralised, bespoke, secure, internet based software solution to provide booking, tracking, reporting and integration of laboratory reports for cancer diagnosis and monitoring, producing one integrated report per patient. The software was developed in partnership with an external Information Technology provider and allows patient samples to be booked into the HODS software at source and sent to the central laboratory from any hospital within the North Trent Network. In addition the software sends an e-mail alert to the referring haemato-oncologist on sample receipt. Once received, the patient sample(s) are dispatched to the relevant diagnostic HODS team for investigation, the HODS software uploads authorised reports produced by the HODS pathologist to a diagnostic review list. Once all the necessary HODS investigations have been completed on the patient's samples the HODS software produces a worksheet that can be used by the HODS pathologists to formulate a final, all encompassing integrated diagnosis based upon World Health Organisation diagnostic coding criteria for haematological cancers. This is made possible by using the HODS software 'reporting' function. Once this is done, the integrated HODS report is immediately available to view by the patient's consultant on a secure web-based browser through the software, which also alerts the consultant, via an automatic e-mail when their patient's integrated report is ready for viewing. The software has built in audit functions to monitor turnaround times and displays 'real time' case report progress. It has an e-learning repository that can be accessed via the web by members of the HODS team and any haemato-oncologists in the network providing access to educational presentations, audit data, quality control reports and network guidelines.
Sandhya Pisharody from Hull and East Yorkshire Hospitals NHS Trust was a finalist with her innovation ‘Planning Workflow Manager’.
Developed in conjunction with the treatment planning staff at the Queen's Centre for Oncology & Haematology at Castle Hill Hospital , the Planning Workflow Manager helps to organize and manage the patient radiotherapy treatment planning process. PWM is a bespoke tool to streamline the multi-stage planning process. Designed to seamlessly interact with the existing Radiation Oncology software suite, PWM integrates the planning process with the overall radiotherapy care stream to ensure early patient treatment delivery. Filtered views of the planning list based on process stage and task assignment aids monitoring & management of individual staff and overall workloads. Quick-glance graphical outputs help to identify bottlenecks and provide an opportunity to follow up as soon as possible. Planners and clinicians can also add comments to individual patient cases to inform other staff of any issues affecting planning or treatment as well as flag up non-conformance to processes or protocols. Radiotherapy treatment staff and booking office staff can track the planning status of patients scheduled for treatment by name, Patient ID or treatment date, ensuring a synchronized patient care process. A bespoke reporting module provides easy access to the collected data for workflow and performance analysis for users with administrative privileges. My role in this project started from requirements gathering and analysis to define the functional specifications for the system, to designing and developing the entire software and associated database, and finally implementation and user training. I am responsible for ongoing support for this system and have implemented a controlled Software Change Request process to manage bug reporting as well as requirements and/or design change requests.
Jonathan Hughes from Sheffield Teaching Hospitals NHS Foundation Trust was a finalist with the ‘Sheffield in-vivo Dosimetry Database (SiDD)’.
Part of the quality assurance process in radiotherapy is the verification of the radiation doses individual patients receive. The 2009 DH Manual for cancer services: draft radiotherapy measures seeks to make a verification technique called in vivo dosimetry (IVD) a requirement for certain treatments. This technique involves a radiation detector being placed in or on the patient to sample the dose of radiation received during a treatment; the reading from the detector is compared to the dose expected from the treatment plan to verify the treatment is being delivered correctly. IVD has the ability to detect and prevent serious radiotherapy errors. WPH have previously purchased several sets of semiconductor diode radiation detectors for use in an IVD programme.
Nuthar Jassam from Leeds Teaching Hospitals NHS Trust was a finalist with her innovation ‘Quality Control Monitoring Software’.
Despite the use of identical technology across the biochemistry laboratories, analytical variability between analysers/laboratories continues to occur for various reasons, both logistical and technical.
Transferability of patients and patient data cannot be achieved unless analytical variability is detected at an early stage i.e. before it impacts on patient results. The previous quality control system had been designed for single, rather than networked laboratories. The change from a single laboratory to network of laboratories has not been accompanied by a change in the quality system. The quality of the analytical process was usually assessed by visually examining data from internal quality control (IQC) and external quality assurance schemes (EQA). Over a one month period, our laboratories produce over a million data points of IQC and at least 427 reports from EQA. Each laboratory reviewed their own data and no access to each others data was possible. Therefore continuous monitoring of the quality data for analysers that are geographically distant by using paper based quality systems is impossible.
The previous system has been replaced by an electronic quality system; Following collaborative work with the analysers manufacturer (Siemens), the IQC data is captured on a regular basis from all 16 analysers in the core biochemistry laboratories. This data is then automatically imported into a data-base.
Following collaborative work with UK External Assurance Scheme Organisers across the country, agreement was reached for them to deliver our EQA data electronically in a pre-agreed format compatible with our database. However, there is a lack of defined quality specifications for quality control at a local/national level. The author has derived a unique form of quality specifications for every test in core biochemistry. These quality specifications relate the analytical performance to the clinical use of a test. This data is fed into the data-base. Mathematical formulae relate the analytical variation to the clinical aspect have been applied to compare results from different sites and to present the data graphically in a single monthly report.